Chemotherapy

Chemotherapy occurs in the infusion room,
located on the third floor of Adventist Medical Center. The
infusion room treatments include, but are not limited to
chemotherapy, blood products, antibiotics, other infusions and
injections. This allows patients to maintain independent
lifestyles and avoid unnecessary hospitalizations. The infusion
room location at the hospital allows for convenient access to
pharmacy, laboratory, X-ray, and other support services.

A physician's referral is necessary to begin receiving
services. Services are available Monday thru Friday by
appointment. For emergent needs other arrangements can be made.
A physician, typically a medical oncologist works with the
nurse, the patient and his/her family to identify infusion
needs. For information please call Infusion Services at
503-261-6631.

What is chemotherapy?

Chemotherapy drugs are potent chemicals, which can control
cancer. Since cancer cells have several ways to survive and
multiply, different drugs have been discovered to kill or at
least slow the growth of cancer cells.

Each drug has a different mechanism of action so combinations
of drugs are often used to fight cancer. There are many
standard combinations used in treatment and many more are being
tested in clinical trials in hopes of improving the ability to
treat disease. Additionally, treatments such as chemotherapy
and radiation or chemotherapy and surgery are used in
combination to improve treatment results.

What are the side effects of chemotherapy?

Historically the side effects of chemotherapy drugs were very
difficult to manage and compromised quality of life or worsened
the outcomes. Now with more advanced supportive care
medications to counteract the side effects of chemotherapy,
cancer treatments are more effective and less toxic. Different
cancer types may require different drug combinations and not
all chemotherapy regimens will have the same side effects.
Although each chemotherapy drug has specific side effects,
common side effects include:

Fatigue

Weakness

Anemia (low blood counts)

Nausea

Hair loss (temporary)

Numbness

Infections

How are chemotherapy drugs administered?

Depending on your type of cancer, chemotherapy drugs are
delivered by different routes:

By mouth

By injection
- Under skin
- Into the muscle
- Into spinal fluid

The intravenous route is the most common method and it allows
the distribution of the anticancer drug to most locations in
the body. Therefore these drugs can be effective both at the
primary site of the tumor, and in places where cancer cells may
have spread.

Intravenous treatment may be delivered over a few minutes to a
few hours. Technological advances now allow the administration
of some intravenous drugs at home through a small device that
delivers the drugs automatically and precisely. This type of
treatment is generally administered over several weeks.

For patients who require ongoing intravenous treatment, a
catheter may be implanted under the skin and connected to a
large vein. The catheter has a metal or plastic "port" and
spares the patient from multiple needle sticks for both blood
draws and drug infusions. The catheter does not interfere with
activities such as bathing or swimming and may be used to
maximize patient comfort. The port may have significant
benefits to the patient in sparing veins in the arms and hands,
which can become very difficult to access and chemotherapy
treatment progresses.

In order to empower patients with knowledge to help them more
effectively fight cancer, there is more specific information
about diseases and treatments available at the National Cancer
Institute site http://www.cancer.gov/.

What is biotherapy or biological therapy?

Biological therapy is a type of treatment that works with the
immune system. It can help fight cancer or help control side
effects from other cancer treatments. Examples of this are
antibody medications, which allow the immune system to better,
recognize and fight cancer cells and hormone-like drugs to
assist in the recovery of low blood counts.

Biotherapy is one of the newest methods to treat cancer and to
help the body recover from the side effects of treatment.
Ongoing research in this area holds a great deal of promise for
improving cancer treatment. Drugs that fall within this
category are interferon, interleukin, and colony stimulating
factors like Neulasta (G-CSF, a granulocyte colony stimulating
factor that increases the white blood cell count) and Aranesp
or Epo (erythropoietin, which increases the red blood cell
count).

What is the difference between biological therapy and
chemotherapy?

Biological therapy and chemotherapy are both treatments that
fight cancer. While they may seem alike, they work in different
ways. Biological therapy helps your immune system fight cancer.
Chemotherapy attacks the cancer cells more directly to stop
their growth.

How is/are biotherapy drugs administered?

Biotherapy drugs may be given into the vein or by an injection
that goes under the surface of the skin. Depending on the type
of medication and the dose, it may be administered in the
hospital or in the physician office. Some people may be able to
self-administer their "shots" at home.

What are the types/names of some common biological therapies?

Different kinds of drugs may be used for biological
therapy--some to fight cancer and some to treat the side
effects of other cancer treatments. Many of the substances used
for biological therapy are similar to substances that naturally
occur in the body. Examples of the types of drugs used for
treatment are interferons, interleukins, colony-stimulating
factors, monoclonal antibodies, and nonspecific
immunomodulating agents. Gene therapy is yet another type of
biological therapy.

Interferons enhance the efficacy of the immune system, and
help it to recognize and attack cancer cells. Interferons may
also act directly on cancer cells by slowing their growth or
causing them to behave more like normal cells. There are three
main classes of interferons: interferon alpha, interferon beta,
and interferon gamma.

Interleukins, such as interleukin-2 (also called IL-2 or
aldesleukin), stimulate the growth and activity of immune
cells. The activated immune cells are then better able to
destroy cancer cells.

Colony-stimulating factors (CSFs) usually do not directly
affect tumor cells. Instead, they encourage your body to make
more white blood cells, platelets, or red blood cells. This
helps counteract the side effects of other cancer treatments.
Examples of CSFs are erythropoietin (also called epoetin,
Procrit, Epogen, or Aranesp) and G-CSF (also called Neupogen or
Neulasta).

Monoclonal antibodies (MOABs or MoABs), such as Rituxan
(rituximab) and Herceptin (trastuzumab), are antibodies created
in the lab. The antibodies can attach themselves to cancer
cells. They may be used to:
- Enhance your immune response to the cancer (Herceptin)
- Help stop the growth of cancer cells (Rituxan)
- Deliver chemotherapy drugs directly to the cancer.
(Mylotarg)

Gene therapy is an experimental treatment that involves
putting specially-engineered genetic material within the tumor.
For example, a gene may be inserted into a tumor to make it
more recognizable to the immune system. Antisense oncogenes can
be used to silence a cancer-related gene.

What are the side effects?

Just like other forms of cancer treatment, biological therapy
sometimes causes side effects. The side effects can vary a lot,
depending on the drug and the person receiving it. The most
common side effects of biological therapies are: